Deputy Prime Minister Vũ Đức Đam inspects the treatment of COVID-19 patients at District 7's field hospital, HCM City, on August 6. VNA/VNS Photo Diệp Trương

Vũ Đức Đam, Deputy Prime Minister and Head of the National Steering Committee for COVID-19 Prevention and Control​​, spoke to the media about the current COVID-19 situation in the southern region, the country’s epicentre, after spending almost a month inspecting prevention and control efforts in the area.

During the trip, you frequently mentioned the formation of ‘green zones’, or COVID-19 free areas. Why this new strategy?

When I visited HCM City, I said the city's COVID-19 outbreak is difficult and we needed to follow the strategy of ‘zoning’ the city for lockdown. But once this city is put under lockdown, hundreds of thousands people would want to leave or return to their hometown, therefore we needed to cover larger surrounding areas as well to prevent the entire region becoming a ‘red zone’ in a short duration.

I submitted the proposal to the Government to implement Directive 16 in HCM City and then the entire southern region, if it had not been done early, the situation would have been even worse now.

The common strategy now for HCM City and the southern provinces under lockdown is to maintain and expand ‘green zones’, narrow down the outbreak regionally and gradually restore normal life.

The entire southern area has been under lockdown for the last 20 days, but cases continue to rise? Can the ‘green zones’ be viable for long?

It’s obvious that if lockdown is carried out strictly and synchronously, the outbreak could be contained within two to four weeks, so in cases where the number of patients continue to go up, it is because of insufficient enforcement, which would necessitate further restrictions, resulting in frustration and economic damages.

It should be noted that ‘under control’ does not mean zero cases, but it means that the hot spot areas would be contained.

It seems that different localities have their own way of implementing ‘four on-site’ principles – leadership, workforce units, vehicles and supplies, and logistics – especially with regards to supplies and leadership. What should local governments do to optimise resources in contact tracing and treatment, or prevention and control efforts?

The four components like you said don’t have to be ‘fixed’ at all times, and each locality would have their own characteristics of tackling an outbreak.

We have created different scenarios if the situation gets worse but most southern region localities only start to devise further scenarios after the outbreak in HCM City reached a severe level. This is also a lesson we can learn from.

Like in the previous outbreaks where only one or two localities – for example, Bắc Ninh and Bắc Giang outbreaks earlier this year, or HCM City in recent times – then the entire country could pool resources there to help battle the outbreak. But if the four on-site principles are not followed, the lockdown is not implemented seriously, and outbreaks occur at several places at once and there cannot be enough support to simultaneously going to all these places, the consequences would be devastating.

Some localities wanted to buy millions of rapid tests, but experts have said that those who use more rapid tests does not mean their situation would improve. What is your opinion on the use of rapid testing in this wave of infections?

The goal of testing is to detect F0 (COVID-19 patients), trace their contacts and isolate the patients and the probable infections from the community. Local authorities should review their situation to decide which types of tests to use at which frequency, in an effective and economical manner.

The health ministry has issued guidelines on matters related to testing and if it is applicable to the entire country, but local governments can make adjustments if needed.

At recent meetings, localities all expressed interest in flexible and proactive treatment. What can you tell us about this?

Based on the health ministry’s three-level treatment stratagem – sorting asymptomatic cases and patients with minimal symptoms into field hospitals, mild cases into COVID-19 hospitals, and serious cases into COVID-19 intensive care centres – localities can make flexible adjustments depending on their own situations.

For example, HCM City has facilities for only asymptomatic COVID-19 cases (not considered ‘patients’ yet) that are strictly managed to ensure no spread of the virus to the outside.

In these facilities, the asymptomatic COVID-19 cases are taken care of both mentally and physically to reduce the rate of them becoming symptomatic.

Củ Chi District in HCM City is one highlight. Their rate of asymptomatic cases progressing into symptomatic is between 5 and 10 per cent, while the average rate is about 20 per cent or even 30 per cent when the facilities are crowded or not well organised.

These are local initiatives that should be promoted. To reduce the number of deaths at the highest level of treatment (intensive care), we need to reduce the rate of patients progressing into serious disease in all the lower levels, especially the first level.

Across the country, the strategy is to prevent and reduce new COVID-19 cases, as our healthcare system cannot cope with large number of cases, for even in the time before the pandemic, many central hospitals had often suffered from overcrowding.

In recent times, with the sharp rise in cases in HCM City, all local hospitals are overloaded. Together with building new hospitals under the guidance of the health ministry, the important thing is also to make use of all existing medical facilities in the city to treat COVID-19 patients when they only showed light symptoms.

During your trip, many businesses have complained of disruptions. How can localities achieve the dual goals of containing the pandemic and promoting socio-economic development?

Lockdown, or social distancing measures, at the provincial or nationwide scale, is good for pandemic control, but not good for the economy, naturally. But if we limit the lockdown to the smallest region possible, the pandemic fight would be much more challenging but the economic damages would be lessened. But no matter what the scale, the restrictions must be properly enforced. Like a forest with many small fires, if we just blockade the perimeters of the forest without caring much for the inside, the fires would soon consume the entire forests, but if we also try to suppress these smaller fires, we could save the forest.

The dual goals have been stated since the beginning of the pandemic, but the goal of protecting public health is always the highest priority and that is what we are doing at the moment with Directive 16.

Placing the entire southern region under Directive 16 serves two purposes: controlling, managing the comings and goings of people from outbreak regions to other areas, and setting up green zones (inter-provincial or intra-provincial) where goods and travel can continue. This area may be under lockdown, but other areas can serve as a ‘supporting’ front, and importantly, the supply chains must not be totally disrupted.

Can the health ministry ensure enough vaccine supplies so that the HCM City can administer 70 per cent of the adult population August?

The Government assigned the health ministry to be the focal point in negotiations and importations of COVID-19 vaccines to get enough doses for the entire population of the country.

But we cannot control the delivery times. By the end of the year, there will be large amount of vaccines incoming, but in the coming weeks, the amount of vaccines arriving from our secured commitments would be insignificant.

With the outbreak as intense as it is, all localities want access to vaccines as early as possible. The Government has discussed the issue and would give priority to HCM City and southern provinces like Đồng Nai, Bình Dương, Long An, etc. where the virus has spread deeply and widely in the community for these localities to reach herd immunity the earliest.

When will the southern region have the outbreaks under control?

The southern region with 19 localities can be divided into three groups.

Group 1, comprising the provinces to the south of the Hậu River, as well as Sóc Trăng, Bến Tre, and Bình Phước, need to be determined to have outbreaks under control after four weeks of Directive 16 lockdown measures end – the clusters are zoned and isolated, the green zones are consolidated and expanded, but not necessarily bringing the cases down to zero yet.

Group 2, comprising of HCM City, part of Đồng Nai, Bình Dương, Long An provinces, is the worst affected region. Đồng Nai, Bình Dương, and Long An should strive to have the outbreaks under control by the end of August, or at the latest, in mid-September along with HCM City.

Group 3, comprising the remaining localities, must contain the outbreaks in 20 days.

As soon as the vaccines arrive, we should aim to administer them all, keep up and widen the green zones, restore business and production activities and people’s travels once conditions permit. It should be noted that vaccines take time to elicit immune responses, and the vaccinated could still be infected with the virus and spread to other people.

So we must have a ‘new normal’ in HCM City region that is different from the rest of the country, which would be similar to some other countries reopening after severe outbreaks and reaching immunity via vaccines. — VNS